| NPI | 1639668486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHAMBLISS Owner 205-453-0314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: AL 5181) |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |